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General NPI Number Information
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NPI Number | 1275521460
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Entity Type | Organization
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Legal Business Name | WALNUT HILLS NURSING AND REHABILITATION, LTD.
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 3509 ROGGE LN
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City | AUSTIN
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State | TX
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Zip | 78723-3640
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Country | US
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Telephone | 512-926-2070
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Fax | 512-926-9570
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Provider Business Mailing Address
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Address Line | 600 E WHALEY ST
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City | LONGVIEW
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State | TX
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Zip | 75601-6525
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Country | US
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Telephone | 903-757-5360
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Fax | 903-753-8621
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Authorized Official
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Title or Position | PRESIDENT
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Name | DICK STEBBINS
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Credential | CPA
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Telephone | 903-757-5360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 111191
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License Number State | TX
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